Study On The Relationship Between Conventional Coagulation Tests And Thrombelastography And Trauma Severity In Patients With Multiple Injuries In Emergency Department

Objective:1.To explore the relationship between conventional coagulation tests(CCTs)and thrombelastography(TEG)in patients with multiple injuries with different severity of trauma;2.Compare the evaluation effect of the two coagulation function examination methods on the coagulation function of patients with multiple injuries,in order to provide reference basis for the diagnosis and intervention of coagulation function in patients with multiple injuries;3.Kampala trauma score(KTS score)was applied in the specialized research of traumatic coagulation disease to increase the relevant information of KTS score.Methods:A total of 126 patients with multiple injuries admitted to the emergency department of large affiliated hospital of shanxi medical university from April to November 2018 were selected and their KTS scores were calculated respectively.According to the KTS scores,126 patients with multiple injuries were divided into light group(14 ~ 16 points),medium group(11 ~ 13 points)and heavy group(5 ~ 10 points).Within 12 h after injury were separately CCTs [including prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB),D-dimer(D-D)),platelet count(PLT)and TEG(including coagulation reaction time(R value),kinetics time(K value),?angle(?),maximum amplitude(MA)?to assess blood coagulation function in patients with multiple trauma,another select healthy check-up 30 as a control during this period,the observed differences in four groups of the experimental indicators;Meanwhile,the correlation between the two test methods in the experimental group was analyzed.Results:There were statistically significant differences in CCTs between FIB,D-D and PLT groups.In TEG test,only MA values were statistically different among the 4groups.Correlation analysis of CCTs and TEG experimental indicators: R value is positively correlated with PT and APTT,and negatively correlated with FIB.K value was positively correlated with APTT and TT,and negatively correlated with FIB and PLT.Alpha correlates positively with FIB,d-d and PLT,and negatively with PT,APTT and TT.MA value was positively correlated with FIB and PLT,and negatively correlated with PT.Conclusion:1.TEG index can reflect the coagulation status of patients with early multiple injuries more comprehensively and truly than traditional coagulation function examination,and can evaluate the types of coagulation dysfunction.The two examination items have different focuses and cannot replace each other.2.It is speculated that it may be more reliable to use TEG to guide the selection of clinical blood products and CCTs as the dosage standard to guide the formulation of individualized blood transfusion scheme.3.PT,PLT and MA values can reflect the severity of trauma,and the above indicators can be given priority when adding coagulation function indicators to the trauma assessment system.